Articular cartilage is a firm, rubbery tissue that covers the articulating surfaces of bones. Articular cartilage provides a smooth gliding surface for joints and acts as a cushion between adjacent bones.
Articular cartilage can break down due to overuse, injury and/or disease. This deterioration of articular cartilage can result in substantial pain and swelling for the patient, and can significantly impact patient lifestyle.
Various treatments have been devised to address the deterioration of articular cartilage. In some circumstances, a plug of bone (with a segment of articular cartilage attached thereto) may be harvested from one part of the body and transplanted to another part of the body, e.g., from a non-weight-bearing section of a joint to a weight-bearing section of a joint. In other circumstances, a prosthetic device (having a smooth bearing surface formed thereon) may be installed in place of the deteriorated articular cartilage. However, the aforementioned plug transplantations, and the aforementioned prosthetic device installations, tend to suffer from a number of deficiencies, e.g., limitations on the types and sizes of cartilage defects which can be treated using these approaches, trauma to the body at the donor site in the case of plug transplantations, performance deficiencies in the case of prosthetic devices, etc.
Recent advances in in vitro cell growth has now made it possible to restore articular cartilage by means of autologous chondrocyte implantation (ACI). More particularly, with this approach, a small portion of healthy articular cartilage (sometimes referred to herein as “a tissue biopsy”, or simply “a biopsy”) is first harvested from a non-critical section of a joint (e.g., in the case of a knee or hip, from a non-weight-bearing section of the knee or hip). The harvested tissue biopsy is then sent to a processing laboratory where it is appropriately processed, i.e., to extract healthy chondrocyte cells from the tissue biopsy and then culture those chondrocyte cells on a carrier matrix for a period of time (e.g., several weeks) so as to produce a healthy, vibrant autologous graft. Thereafter, in a follow-up procedure, the implant site is prepared to receive the autologous graft, the autologous graft is properly sized for the implant site, and then the autologous graft is introduced into the body and seated at the implant site.
Preferably the foregoing ACI procedure is conducted as an arthroscopic (i.e., as a minimally-invasive, “keyhole surgery”) procedure so as to minimize trauma to the tissue of the patient and thereby accelerate the recovery period for the patient.
While the aforementioned ACI procedure offers tremendous advantages for the patient, it currently suffers from the lack of effective arthroscopic instrumentation for (i) harvesting a tissue biopsy from a non-critical section of a joint, and (ii) sizing and seating an autologous graft at an implant site.
Thus there is a need for new and improved arthroscopic instrumentation for (i) harvesting a tissue biopsy from a non-critical section of a joint, and (ii) sizing and seating an autologous graft at an implant site.